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Periodontics II, Module I > 3. New Classifications > Flashcards

3. New Classifications Flashcards

1
Q

2018 CLASSIFICATION FOR PERIODONTAL AND PERI-IMPLANT DISEASES AND CONDITIONS
Workgroup 1: ____ health and gingival diseases and conditions
Workgroup 2: ____
Workgroup 3: Other conditions affecting the ____
Workgroup 4: ____ diseases and conditions

A

periodontal
periodontitis
periodontium
peri-implant

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2
Q

Periodontal Health, Gingival Diseases and Conditions

  1. ____ and gingival health
  2. gingivitis: dental ____-induced
  3. gingival diseases: ____-dental biofilm-induced
A

periodontal
biofilm
non

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3
Q

Workgroup 1

Four categories of periodontal health

1.1 ____ periodontal health (rare but realistic)
Total absence of clinical inflammation

A

pristine

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4
Q

Workgroup 1

  1. 1 Pristine periodontal health (rare but realistic)
    - No ____, edema or pus
    - Probing ≤ ____ mm (PD)
    - No ____ on probing (BoP)
    - No ____ (AL)
    - No ____ loss
A 
erythema
3
bleeding
attachment loss
bone
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5
Q

Workgroup 1

1.2 Clinically periodontal healthy:
Absence or minimal levels of clinical inflammation

  • Probing ≤ ____ mm (PD)
  • ____ bleeding on probing (BoP) < 10%
  • No ____ (AL)
  • No ____ loss
A

3
minimal
attachment loss
bone

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6
Q

Workgroup 1

1.3 Periodontal disease stability:
Absence or minimal levels of clinical inflammation

  • Probing depth ≤ ____ mm (PD)
  • ____ bleeding on probing (BoP) < 10%
  • ____ (AL)
  • ____ loss
A

4
minimal
attachment loss
bone

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7
Q

Workgroup 1

1.3 Periodontal disease stability:
Successfully periodontal ____
Optimal reduction of ____, AL, minimal BoP
Lack of ____ destruction

A

treated
PPD
progressive

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8
Q

Workgroup 1

1.4 Non-periodontitis patient:
Systemic disease affecting the periodontium

  • Probing depth ≤ ____ mm (PD)
  • ____ bleeding on probing (BoP) < 10%
  • ____ (AL)
  • ____ bone loss
A

3
minimal
attachment loss
possible

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9
Q

Workgroup 1

____ categories of plaque-induced gingivitis and modifying factors

A

three

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10
Q

Workgroup 1

2.1 Associated with dental biofilm only: 
Due to bacterial \_\_\_\_ accumulation
\_\_\_\_ response of the gingival tissues 
Most \_\_\_\_ form of periodontal disease
Begins at the \_\_\_\_
Extend to the remaining gingival unit
A

plaque
inflammatory
common
gingival margin

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11
Q

Workgroup 1

\_\_\_\_ with tooth brushing / in saliva 
\_\_\_\_
Gingival \_\_\_\_
Erythema
\_\_\_\_
No \_\_\_\_ loss
No \_\_\_\_ loss
A 
bleeding
tenderness
swelling
halitosis
attachment
bone
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12
Q

Workgroup 1

Intensity of signs and symptoms:

  • Vary among ____
  • Vary among sites within a ____

Control of gingival ____ is essential for the primary prevention of periodontitis

A

individuals
dentition
inflammation

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13
Q

Workgroup 1

  1. 2 Potential modifying factors of plaque-induced gingivitis
    - ____ conditions
    - ____ enhancing plaque accumulation
A

systemic

oral factors

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14
Q

Workgroup 1

2.2 Potential modifying factors of plaque-induced gingivitis:

Systemic conditions:
Sex steroid hormones
- \_\_\_\_
- Menstrual cycle
- \_\_\_\_
- Oral contraceptives

____
Leukemia
____
Malnutrition

A

puberty
pregnancy

hyperglycemia
smoking

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15
Q

Workgroup 1

2.2 Potential modifying factors of plaque-induced gingivitis:

Oral factors enhancing plaque accumulation

  • Prominent ____ restorations margin
  • ____
  • Pregnancy ____
A

subgingival
hyposalivation
gingivitis

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16
Q

Workgroup 1

  1. 3 Drug influenced gingival enlargements:
    - Antiepileptic: ____ and sodium valproate
    - Calcium channel blocking drugs: ____, verapamil, amlodipine
    - Immunoregulations drugs: ____
    - High-dose ____
A

phenytoin
nifedipine
ciclosporine
contraceptives

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17
Q

Workgroup 1

2.3 Drug influenced gingival enlargements:

Extent:

  • ____ (single tooth or group of teeth)
  • ____ (throughout the dentition)

Severity:

  • ____ (enlargement of papilla),
  • ____ (papilla and marginal gingiva)
  • ____ (extends to the attached gingiva)
A

localized
generalized

mild
moderate
severe

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18
Q

Workgroup 1
Plaque-induced gingivitis (all 3 categories)

Extent:

  • ____ < 30%
  • ____ ≥ 30%
A

localized

generalized

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19
Q

Workgroup 1

Plaque-induced gingivitis (all 3 categories)

Severity: gingival index by Loe (1967)

0
Gingival status: ____ gingiva
Crtieria: Natural color ____ gingiva
No ____

1
Gingival status: \_\_\_\_ inflammation
Crtieria: Slight changes in \_\_\_\_ 
Slight \_\_\_\_
No \_\_\_\_ on probing
2
Gingival status: \_\_\_\_ inflammation
Crtieria: \_\_\_\_
\_\_\_\_ and glazing 
\_\_\_\_ upon probing
3
Gingival status: \_\_\_\_ inflammation
Crtieria: Marked \_\_\_\_ and edema 
\_\_\_\_
Spontaneous bleeding
A

normal
pink
inflammation

mild
color
edema
bleeding

moderate
redness
edema
bleeding

severe
redness
ulceration

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20
Q

Workgroup 1

3.1 genetic/developmental disorders

____ (HGF)

A

hereditary gingival fibromatosis

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21
Q

Workgroup 1

3.2 Specific infections
Bacterial origin: ____
Viral origin: ____ 1⁄2, HPV Fungal origin: ____

A

streptococcal gingivitis
herpes simplex
candidiasis

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22
Q

Workgroup 1

3.3 Inflammatory and immune conditions and lesions Hypersensitivity reactions: ____ allergy
Autoimmune diseases of skin and mucous membranes: ____, lichen planus, lupus erythematosus
Granulomatous inflammatory conditions: ____

A

contact
pemphigus vulgaris
sarcoidosis

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23
Q

Workgroup 1

3.4 Reactive processes
____
Peripheral giant cell granuloma
____

A

pyogenic granuloma

central giant cell granuloma

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24
Q

Workgroup 1

3.5 Neoplasms
____: leukoplakia, erythroplakia
____: squamous cell carcinoma

A

premalignant

malignant

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25
Q

Workgroup 1

3.6 Endocrine, nutritional, metabolic diseases 
\_\_\_\_ deficiencies
\_\_\_\_ deficiency (scurvy)
A

vitamin

vitamin C

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26
Q

Workgroup 1

3.7 Traumatic lesions
Physical/mechanical insults: ____
Chemical (toxics) insults: ____ Thermal insults: ____ of mucosa

A

tooth brushing
chlorhexidine
burns

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27
Q

Workgroup 1

3.8 Gingival pigmentation ____
____-induced pigmentation ____ tattoo

A

smoker’s melanosis
drug
amalgam

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28
Q

Periodontitis

  1. ____ diseases
  2. ____
  3. periodontitis as a manifestation of ____
A

necrotizing periodontal
periodontitis
systemic disease

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29
Q

Workgroup 2

____ categories of Necrotizing Periodontal Disease

A

three

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30
Q

Workgroup 2
1.1 Necrotizing gingivitis
Acute inflammatory process of the ____ tissues

A

gingival

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31
Q

Workgroup 2

  1. 1 Necrotizing gingivitis
    - ____ of the interdental papillae
    - Gingival bleeding
    - ____
    - Halitosis
    - ____
    - Regional lymphadenopathy - Fever
A

necrosis/ulcer
pain
pseudomembranes

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32
Q

Workgroup 2

1.2 Necrotizing periodontitis
Inflammatory process of the ____

A

periodontium

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33
Q

Workgroup 2

  1. 2 Necrotizing periodontitis
    - Necrosis/ulcer of the interdental papillae
    - Gingival bleeding
    - Pain
    - Halitosis
    - Pseudomembranes
    - Regional lymphadenopathy - Fever
    - ____ loss
A

rapid bone

34
Q

Workgroup 2

1.3 Necrotizing stomatitis
____ inflammatory condition of the periodontium

A

severe

35
Q

Workgroup 2

  1. 3 Necrotizing stomatitis
    - Necrosis/ulcer extends ____ the gingiva
    - Gingival bleeding
    - Pain
    - Halitosis
    - Pseudomembranes
    - Regional lymphadenopathy - Fever
    - ____ in the alveolar mucosa
    - ____ and bone sequestrum
A

beyond
bone denudation
osteitis

36
Q

Workgroup 2

____ categories of Necrotizing Periodontal Disease

Host immune impairment:

  • ____
  • Malnutrition
  • ____ infections
  • Stress
A

three
immunosuppression
viral

37
Q

Workgroup 2

Three categories of Necrotizing Periodontal Disease

  • ____
  • ____
  • ____
A

papilla necrosis
bleeding
pain

38
Q

Workgroup 2

Stages (I, II, III, IV)

Severity of the disease

  • ____ loss
  • Radiographic bone loss
  • ____ loss

Complexity of disease management

  • ____
  • Horizontal bone loss
  • ____ loss
  • Furcation involvement
  • ____ mobility
  • Ridge deficiencies
  • ____ dysfunction
A

clinical attachment
tooth

probing depth
vertical bone
tooth
masticatory

39
Q

We are going to talk about general (dont understand..sorry). And we are going to mention it later on , so you can be more familiarized with the classification. Typically, when we talk about stage I and II, we talk about ____mm of attachment loss, more than ____ is stage III and IV. The radio graphical bone loss uses guidelines.

When he came back to this: In terms of the tooth, stage I and II, there is no tooth loss due to periodontitis. In stage III, you have ____ loss , less than 4. In stage IV, you have more than ____ teeth loss due to periodontitis.

In terms of complexity, for stages 1-2 , mainly ____ bone loss and stage III we have also ____ bone loss and ____ involvement.

In stage IV, there is a more advanced scenario. It’s complex. Its ____, bite collapse, less than 10 teen remaining in the patient. They need a complex treatment, prosthetically and periodontically.

A

1-4
5

tooth
5

horizontal
vertical
furcation

malocclusion

40
Q

They divide the roots into thirds. Coronal, middle, and apical third and based on that they look to see where bone loss is located and they say if its in the coronal third, its in stage ____. If its in the middle third its in stage ____

A

I and II

III and IV

41
Q

Workgroup 2

Extent and distribution
Localized (____%)
____ pattern

A

30
30
molar-incisor

42
Q

Workgroup 2

Degree (A,B,C)
Disease progression

Direct evidence

  • ____
  • RBL

Indirect evidence

  • % ____
  • phenotype

Risk factors

  • ____
  • diabetes
A

CAL
bone loss/age
smoking

43
Q

Workgroup 2

With direct evidence, we have the phenotype that is more ____, so we see the patient and have little plaque or calculus or almost none and there is a lot of bone loss, mobility severe, then it is not directly proportional to the amount of dental plaque for the clinical scenario that the patient has is grad ____.

To the contrary, if we see a lot of dental plaque and calculus and its light bone loss, we put it under the category of grade ____. The risk modifies, smoking and diabetes, we give them grade A-no smoker no diabetes, B-less than ____ cigs a day, and C-mor than ____ cigs a day. And for diabetes, less than ____ HbA1c and more than 7.0 HbA1c for people with grade C.

So if the patient bone attachment loss did not change in 5 years, but the patient smokes a lot, more than 10 cigs, then we go to grade ____. So we always look for the most advanced factor that can be contributing to the periodontal
Condition.

A

subjective
C

A
10
10
7.0

C

44
Q

Other conditions affecting the periodontium

  1. ____ diseases affecting the Periodontium
  2. ____ and Endodontic-Periodontal Lesions
  3. ____ Deformities
  4. ____ Occlusal Forces
  5. ____ and Tooth Related Factors
A 
systemic
periodontal
mucogingival
traumatic
prosthesis
45
Q

Other conditions affecting the periodontium

  1. ____ diseases affecting the Periodontium
  2. ____ and Endodontic-Periodontal Lesions
  3. ____ Deformities
  4. ____ Occlusal Forces
  5. ____ and Tooth Related Factors
A 
systemic
periodontal
mucogingival
traumatic
prosthesis
46
Q

Workgroup 3

Disorder:
Down syndrome

Strength of association
- ____

A

moderate

47
Q

Workgroup 3

Disorder; strength of association

  • obesity; ____
  • diabetes mellitus; ____
  • osteoporosis; ____
A

significant
significant
significant

48
Q

Workgroup 3

periodontal abscesses

Localized ____ accumulation
Within the wall of the ____/sulcus
Significant ____ breakdown

A

pus
periodontal pocket
tissue

49
Q

Workgroup 3

Periodontal abscesses

  • ____ elevation (gingiva and lateral part of the root)
  • Bleeding on probing
  • ____
  • Suppuration
  • Deep ____
  • Tooth mobility
A

ovoid
pain
periodontal pocket

50
Q

Workgroup 3

Periodontal abscesses in periodontitis patients

Untreated patients: (____)

Treated patients:

  • After scaling and root planning (remaining ____)
  • After periodontal surgery (____, membranes)
  • Systemic antimicrobial (without ____ debridement)
A

periodontal pocket
calculus
sutures
subgingival

51
Q

Workgroup 3

Periodontal abscesses in non-periodontitis patients

Healthy sites:

  • Impaction of ____ (dental floss, popcorn)
  • Harmful ____ (nail biting, biting wire)
  • ____ factors (inadequate orthodontic forces)
  • Gingival ____
A

foreign bodies
habits
orthodontic
enlargement

52
Q

Workgroup 3

Endodontic Periodontal Lesions

____ communication between the pulpal and periodontal tissue

A

pathologic

53
Q

Workgroup 3

Endodontic periodontal lesions

  • Deep periodontal pocket extending to the ____ (primary sign)
  • Negative/altered response to ____ tests
  • Radiographic evidence of ____ in the apical or furcation region
A

root apex
pulp vitality
bone loss

54
Q

Workgroup 3

Endodontic Periodontal lesions

  • ____ pain
  • Pain on palpation/percussion
  • Purulent ____/suppuration
  • Tooth mobility
  • ____/fistula
  • Crown and/or gingival color alterations
A

spontaneous
exudate
sinus tract

55
Q

Workgroup 3

Endodontic Periodontal Lesions

Perio-endo ifnection
Caries > \_\_\_\_
Periodontitis > \_\_\_\_
Periodontitis > \_\_\_\_
CHRONIC
Trauma and iatrogenic factors
\_\_\_\_ or cracking
root canal or pulp chamber perforation
\_\_\_\_ root resorption
ACUTE
A

periodontium
root canal
caries

root fracture
external

56
Q

Workgroup 3

Mucogingival deformities and conditions around teeth

1. Periodontal biotype
Thin scalloped biotype:
- \_\_\_\_ triangular crown
- \_\_\_\_ cervical convexity
- Interproximal contacts close to the \_\_\_\_ 
- \_\_\_\_ KT
- \_\_\_\_ gingiva
- \_\_\_\_ alveolar bone
A 
slender
subtle
incisal edge
narrow
thin
thin
57
Q

Workgroup 3

Mucogingival deformities and conditions around teeth

1. Periodontal biotype
Thick flat biotype:
- \_\_\_\_-shape tooth crowns
- \_\_\_\_ cervical convexity
- Interproximal contacts more \_\_\_\_ 
- \_\_\_\_ zone of KT
- \_\_\_\_ gingiva
- \_\_\_\_ alveolar bone
A 
square
pronounced
apical
broad
thick
thick
58
Q

Workgroup 3

Mucogingival deformities and conditions around teeth

  1. Gingival / soft tissue recession
    - ____, lingual surfaces, ____
A

facial

interproximally

59
Q

Workgroup 3

Mucogingival deformities and conditions around teeth

  1. Gingival / soft tissue recession - Severity of recession (Cairo Classification) Recession Type 1 (RT1):
    Gingival recession with no loss of ____

____ is clinically not detectable at both mesial and distal aspects of the tooth

A

interproximal attachment

interproximal CEJ

60
Q

Workgroup 3

Mucogingival deformities and conditions around teeth

  1. Gingival / soft tissue recession - Severity of recession (Cairo Classification)

Recession Type 2 (RT2):
____ recession associated with loss of ____
Interproximal AL is less than or equal to the ____

A

gingival
interproximal attachment

buccal attachment loss

61
Q

Workgroup 3

Mucogingival deformities and conditions around teeth

  1. Gingival / soft tissue recession - Severity of recession (Cairo Classification)

Recession Type 3 (RT3):
Gingival recession associated with loss of ____
Interproximal AL is ____ than the buccal attachment loss

A

interproximal attachment

greater

62
Q

Workgroup 3

Mucogingival deformities and conditions around teeth

  1. Gingival / soft tissue recession
    - Gingival thickness = ____ mm
A

1

63
Q

Workgroup 3

Mucogingival deformities and conditions around teeth

  1. Gingival / soft tissue recession - Gingival width = ____ mm
  2. Lack of ____ gingiva
  3. Decreased ____ depth
  4. Aberrant ____/muscle position
  5. Gingival ____
A 
2
keratinized
vestibular
frenum
excess
64
Q

Workgroup 3

Traumatic occlusal forces

primary occlusal trauma > ____ occlusal forces (tooth/teeth) > normal ____ support:

  • ____ CAL
  • ____ BL
A

excessive
periodontal
normal
normal

65
Q

Workgroup 3

Traumatic occlusal forces

Secondary occlusal trauma > ____ occlusal forces (tooth/teeth) > ____ periodontal support:

  • ____ loss
  • ____ loss
A

normal/excessive
reduced
clinical attachment
bone

66
Q

Workgroup 3
Traumatic occlusal forces

Clinical and radiographic indicators of occlusal trauma

  1. ____
  2. Mobility
  3. ____ discrepancies
  4. Wear facets
  5. Tooth ____
  6. Fractured tooth
  7. ____ sensitivity
  8. Discomfort / pain on chewing
  9. Widened ____ space
  10. Root resorption
  11. ____ tear
A 
fremitus
occlusal
migration
thermal
PDL
cemental
67
Q

Workgroup 3

Localized tooth related factors

  1. Tooth anatomic factors
    - ____ projections
    - Developmental ____ groove
  2. Root ____
  3. Cervical root resorption, cemental tears
  4. Root ____
  5. Altered passive eruption
A

cervical enamel
palatal
fractures
proximity

68
Q

Workgroup 3

Localized dental prosthesis related factors

  1. Restoration margins placed within the ____ attached tissues
  2. Clinical procedures related to the fabrication of ____ restorations
  3. Hypersensitivity / toxicity reactions to ____
A

supracrestal
indirect
dental material

69
Q

Peri-Implant Diseases and Conditions

  1. Peri-Implant ____
  2. Peri-Implant ____
  3. ____
  4. Peri-Implant ____ Tissue Deficiencies
A

health
mucositis
implantitis
soft and hard

70
Q

Workgroup 4

Peri-implant health

  • Masticatory and lining ____
  • Mucosa averages high ____mm from mucosal margin to the crest of the peri-implant bone
  • Papilla height between an implant-supported restoration and natural tooth is ≤ ____ mm
A

mucosa
3-4
5

71
Q

Workgroup 4
Peri-implant Health
- Following implant, ____mm of bone occurs
- PD > ____mm mm and/or crestal bone loss ≥ ____mm mm should be investigated for pathology
- After this initial period 75% of implants experience no additional ____mm

A

5
2
bone loss

72
Q

Workgroup 4
Peri-implant Mucositis
- ____
- ____ weeks for resolution

A

reversible

3

73
Q

Workgroup 4
Peri-implant Mucositis
- Predisposing factors: ____, cement
- Plaque accumulation results in more severe ____ response around implants compared to natural teeth

A

plaque

inflammatory

74
Q

Workgroup 4
Peri-implantitis

  • Difficult to define what is the normal ____ range around implants
  • Hx of ____ disease is a risk factors for peri-implantitis
  • Data for smoking and diabetes is ____
A

PD
periodontal
inconclusive

75
Q

Workgroup 4
Peri-implantitis
- Compliance with ____ interval reduces the risk of peri-implantitis
- ____: potential risk factor
- No evidence that ____ is a risk factor peri-implantitis

A

maintenance
cement
occlusal overload

76
Q

So a patient with peri-implant health has no inflammation, no bleeding, and there isn’t an increase in probing depth in future visits.The patient is stable. There is no more bone loss after the initial bone remodeling.

Peri-implant mucositis has ____, ____ , ____, but no ____. For peri-implantitis we have all 4 of them.

A

inflammation
BOP
probing depth
bone loss

77
Q 
Good (one or more of the following)
• Adequate periodontal \_\_\_\_ (clinically and radiographically) 
• \_\_\_\_ to maintain
• Adequate patient \_\_\_\_
• Control of the \_\_\_\_ factors
A

support
easy
cooperation
etiologic

78
Q

Fair (one or more of the following)
• Approximately ____% attachment loss (clinically and radiographically)
• ____ furcation involvement / Proper maintenance
• Acceptable patient ____

A

25
class I
cooperation

79
Q

Poor (one or more of the following)
• ____% attachment loss (clinically and radiographically)
• ____ furcation involvement / Proper maintenance with difficulty

A 
50
class II
80
Q

Questionable (one or more of the following)

  • Greater than ____% attachment loss (clinically and radiographically)
  • Poor ____ ratio
  • ____ furcation not easily accessible
  • ____ furcation
  • Mobility Grade ____ or greater
  • Significant root ____
A 
50
crown-to-root
class II
class III
2
proximity
81
Q

Hopeless
• Inadequate ____ to maintain the tooth
• ____ performed or suggested

A

attachment

extraction

Periodontics II, Module I (19 decks)

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